Advice and Resources for the Biotech Industry

Advice and Resources for the Biotech Industry

It’s time once again for my annual roundup of some of the best books I've read this year. As usual, my focus is on non-fiction tales from the world of science, medicine, and technology. A master list of all books that I recommend can be found here, and you can also check out my previous book recommendations from 2016 and 2015. Here's my latest list:

Disrupted: My Misadventure in the Start Up Bubbleby Dan Lyons (2016). Lyons was formerly the chief technology writer for Newsweek magazine, and he also attracted a lot of attention with his alternate identity as recounted in his Fake Steve Jobs blog. The declining economics of the publishing industry catch up with him, and he gets downsized. What to try next to pay the bills? He lands a job as a “marketing fellow” at HubSpot, a marketing-focused Boston start-up with more money than common sense. Disrupted is his hilarious account of his misadventures at the company, where he’s twice the age of nearly every employee and is dumbfounded by it’s unusual (to him) culture. This includes the wearing of orange clothes and shoes, dogs roaming the hallways, and the incredibly large collection of candy dispensers provided for the worker bees. He finds amusement in the seemingly endless supply of emails telling the employees that they are awesome!!!, or that explain that so and so has “graduated” the company (their euphemism for fired) and is looking at new opportunities. Whether you’ve spent time in this type of environment or not, it is clearly ripe for skewering, and Lyons wields the sword in a most entertaining way.

Grunt: The Curious Science of Humans at War by Mary Roach (2016). I’m a big fan of Mary Roach’s writing. This book covers her usual spectrum of subjects not for the squeamish, including penis reconstructive surgery and a number of subjects that military science seeks to solve. These include coping with high temperatures in mid-east combat zones, escaping from crippled submarines on the ocean floor, and efforts to make stink bombs that smell so bad they drive the enemy out of their territory. It also documents efforts to devise effective universal shark repellents (current ones appear to be species specific), dealing with diarrhea in a combat theater, how it was discovered that maggots are better than surgeons at debriding wounds, and the serious foot problems caused by the detonation of IEDs beneath vehicles. The book is full of funny yet cringe-inducing anecdotes, while conveying the author’s deep respect for the work done by the armed forces scientists and medical personnel. The challenges they face, as well described in this book, are many. No matter what subject she writes about (and she’s already covered sex, guts, and cadavers in previous books), you can count on solid reporting with a humorous touch.

Forensics: What Bugs, Burns, Prints, DNA and More Tell Us About Crime by Val McDermid (2015).Everything you ever wanted to know about forensics that the various versions of CSI didn’t go into, or didn’t get quite right. The book covers a wide variety of investigative techniques, including fingerprint analysis, arson investigation, how bugs devourer corpses, pathology analysis, toxicology limits, facial reconstruction, and a number of other areas. It also covers the process of how expert witnesses are vetted and prepped for courtroom testimony. Written with a bit of a historical perspective of how the various forensic techniques were initially adopted and then widely used. If you’re considering a career in a police lab or as an attorney prosecuting or defending criminals, this book is one that belongs on your nightstand.

Forensics work is not limited to murder mysteries. Check out Sorting the Beef from the Bull: The Science of Food Fraud Forensicsby Richard Evershed and Nicola Temple (2016). Who knew that there were so many ways illegal ways to tamper with food? The authors describe in great detail, by food category or type, the lengths that con artists and thieves go to in order to rip off consumers. All of the sickening details are here for those of you with a strong constitution. Adulterated honey. Fake eggs. Melamine in Chinese milk. Olive oil that is anything but pure. Fish that are more often than not mislabeled as to the species on the label. Ground spices that contain a lot more filler than the advertised spice. The authors not only tell you the tricks used by the duplicitous scammers, they describe the various analytical techniques that have been developed in order to detect the fraud. The book makes a strong case that without regulation by both government and trade associations, we would be putting much less healthy things in our mouths on a daily basis, and at a significant cost to our well being as well as our pockets.The Truth in Small Doses: Why We Are Losing the War on Cancer- And How to Win It by Clifton Leaf (2014). This was an interesting book. The most valuable section was a discussion of cancer statistics and how they are normalized to reflect changes in population size and aging. The data show that for a number of cancers, the actual rate has continued to increase in the US over a very long period of time (except for a number of childhood cancers and one particular adult leukemia). The author points out why our system of funding cancer research is geared towards the status quo, and the near impossibility of winning grants for ideas outside of the mainstream. A number of good stories are used to illustrate the role of those who exhibited outside the box thinking. The primary weakness: the author, who is not a biomedical professional, makes the same mistake that others in this area make: he considers cancer an engineering problem to be solved. If we could engineer a landing on the moon, why not cure cancer? Biology is infinitely more complicated than rocket science, which is why computer coders won’t solve it either.

The Cancer Chronicles: Unlocking Medicines’s Deepest Mystery by George Johnson (2014). This book covers a wide spectrum of topics in a rather random and disorganized way. Mixed in from time to time are stories about the author’s wife (and later brother) and their battles with cancer. The writing is good, but there is no overarching theme, and the connection between chapters is tenuous. It does, however, cover topics that don’t frequently pop up in books about cancer. These include the identification of tumors in the fossilized bones of dinosaurs, and a discussion of how cancer might have been viewed by ancient civilizations. I’d suggest reading Clifton Leaf’s book (see above) before turning to this one, and of course one can also turn to one of my previous recommendations: Siddhartha Mukherjee’s excellent Pulitzer Prize winning The Emperor of All Maladies: A Biography of Cancer.

In Twinkie, Deconstructed (2008) writer Steve Ettlinger takes apart, both literally and figuratively, one of America’s classic junk food treats. The format is pretty simple: he starts with a list of ingredients for this devilish yellow snack, and then, chapter by chapter, examines the history of that ingredient, how it’s produced, and it’s role in the taste, appearance, and shelf life of the Twinkie. It’s all done with a light hand, and you will learn more than you ever wanted to know about wheat varieties, polysorbate 60, eggs, soy, and leavening. The book provides an introductory look at food creation technologies through the eyes of a science writer. Those with a taste for the iconic filled golden cakes are the primary audience for this detailed deconstruction. Give it a pass if you don’t want the chemistry to ruin your enjoyment of this well loved treat. Note: in contrast to rumors you may have heard, Twinkies really do come with a “best buy” date. One produced today will not be edible in the 22nd century.

The Sixteenth Rail – The Evidence, The Scientist, And The Lindbergh Kidnapping by Adam J. Schrager (2013) was a thoroughly engrossing read. It tells the story of Arthur Koehler, who in the early 1930’s was a scientist employed by the U.S. Forest Service Products Lab in Madison, WI. He was an expert on all things related to wood. After the kidnapping and death of Charles and Anne Morrow Lindbergh’s baby son in 1932, Koehler was brought in to examine the hand-made ladder that was used to snatch the baby. Much of the book is devoted to his investigation of the ladder, along with the development of the forensic science of wood analysis. The effort he and others made to track down the source of the wood was truly Herculean; I had no idea that these capabilities existed at that time. In the end, testimony from the “Wood Wizard” was crucial in convicting the kidnapper and sending him to the electric chair. A nice portrait of a basic research scientist who moves beyond his regular job of identifying wood samples to play a key role in what was, for much of the 20th century (and before anyone ever heard of O.J. Simpson), the crime of the century.

Money Driven Medicine: The Real Reason Healthcare Costs So Much by Maggie Mahar (2006). This is one of the best books I’ve read in a long time, but it’s not an easy read. Fact dense and deeply referenced, it looks into numerous facets of our health care system to determine why it is so flawed and expensive. It examines the role of doctors, insurers, medical device and pharma companies, pharmacy benefit managers, and hospitals (both for and non-profit) to produce a damning portrait of a healthcare system that clearly doesn’t work as well as we’d like it to. Bottom line: medicine is so expensive because so many different groups have their fingers in the healthcare pie, and they are all focused on taking very large bites. My only disappointment with the book is that it was written before the passage of the Affordable Care Act (Obamacare), which would have made an interesting subject to weave into the overall narrative.

Truevine: Two Brothers, a Kidnapping, and a Mother’s Quest: A True Story of the Jim Crow South by Beth Macy (2016). This rambling book tells the story of two albino black boys, George and Willie Muse, who were “abducted” when they were little and forced into a life of being exhibited as freaks in circus sideshows in the decades leading up to the Great Depression. Their mother launched a lengthy search to find her missing boys, which she finally did after 14 years. She wound up suing the Ringling Brothers and Barnum and Bailey Circus and, against all odds, got a settlement that helped pay for the boys care as they aged. The story plays out against a finely woven portrait of just how poorly blacks were treated in the rural south (the book is largely set in the Roanoke, VA area) during the Jim Crow era. Also interesting are the descriptions of the circus life at a time when this was a major form of entertainment for a majority of Americans. Contrasts are laid out between attitudes in the early 1900’s, when gawking at the physically disadvantaged was considered entertainment, with current thinking about the rights of the disabled. At the time, the disabled had few options for earning a living, which is why many decided that joining circus sideshows was their best option for staying out of the poorhouse.

Dreamland: The True Tale of America’s Opioid Epidemic (2015) by Sam Quinones. This is a very well researched and clearly explained story of how many cities in America came to be overwhelmed by opioids. The author goes back and forth (in time and geographically) to trace the epidemic to two sources: a network of black tar heroin dealers operating out of a small farm town in Mexico, and prescription opioids that really took off with the marketing campaign by Purdue Pharma of their time release oxycodone drug Oxycontin. Just to illustrate the size of the prescription drug problem, 12 states had more opioid prescriptions written last year than people actually living in those states. The devastating effects of this epidemic on both individual families and whole communities (especially in parts of Appalachia) are laid out in heartbreaking detail. Much of the problem arose due to the erroneous interpretation of a letter to the editor in a medical journal suggesting that opioids were not addictive (they clearly are). One nice added touch: a look at the business models used by both the Mexican drug dealers (who use a pizza delivery model and operate separately from the violent drug cartels that we usually read about) and prescription drug maker Purdue Pharma. A nice follow-up to this book would be Methland: The Death and Life of an American Small Town by Nick Reading (2010). It covers an equally interesting story and describes how methamphetamine addiction overtook the heartland of America.

Strangers in Their Own Land: Anger and Mourning on the American Rightby Arlie Russell Hochschild (2016). Many people living in Blue states are still trying to figure out why so many people in other parts of the country voted for Donald Trump in 2016. This book offers an in-depth explanation for what attracted them, and why they were willing to overlook so many of his obvious flaws. The author is a sociology professor at UC-Berkeley. She picked one state (Louisiana) and one key issue (environmental pollution), and then interviewed numerous folks in bayou country to find out what the thinking was behind their votes. This is an important book that clearly describes several different (but widely held viewpoints) that explain why a majority of the citizens in Louisiana are more concerned with jobs, religion, and government regulations than the serious industrial pollution occurring literally in their back yards by multi-national petrochemical plants.

Do No Harm: Stories of Life, Death, and Brain Surgery by Henry Marsh (2014). This book contains a collection of stories written by retired British neurosurgeon Marsh. Each chapter is essentially written to describe a particular type of disease or medical problem (e.g. astrocytoma; stroke; ependymoma) that he has treated over the years. I’m recommending this book even though the writing isn’t stellar and the quality of the chapters is quite variable. What I liked best about this book are the honest descriptions of what Marsh could and couldn’t do in the operating room. We rarely see books like this where the author is willing to admit to numerous mistakes both he and his colleagues have made over the years, most of which led to devastating outcomes for his patients. Neurosurgery is a specialty where many things can and do go wrong, and when that happens the problems are often unfixable. The outcomes of even successful surgeries are frequently sad (e.g. he successfully removes a brain tumor, but knows that it will recur in a much more malignant form). This is not a book that patients facing neurosurgery (especially brain tumors) will want to read before heading to the hospital.

City on Fire: The Forgotten Disaster That Devastated a Town and Ignited a Landmark Legal Battle by Bill Minutaglio (2003) is built around the man-made disaster that struck Texas City, Texas on April 16, 1947. After WWII, U.S. chemical factories were ordered to continue producing ammonium nitrate. During the war this was used to make explosives, but afterwards its use was directed towards fertilizers to help prevent starvation across war-damaged Europe and Japan. Two devastating explosions of ammonium nitrate fertilizer stored onboard freighters docked in the city’s harbor destroyed most of the city of 15,000. They killed over 500 people, wiped out entire neighborhoods, and reduced most of the petrochemical factories and oil refineries to rubble. The chemical plants in the area, where most of the people in the city worked, were technically outside of the city limits. This meant that they paid no taxes and were exempt from any local regulations. The survivors and the kin of those who died eventually sued the U.S. government for neglect. They charged the government with failing to warn about the dangers of transporting the hazardous fertilizer, and they ultimately won a landmark ruling in federal court. The case was appealed up to the Supreme Court, where the plaintiffs lost because the court decided that the government could basically due whatever it wants without being held accountable. The book is filled with many small stories about notable people in the city, including the mayor, a Catholic priest, and the heroic head of the volunteer firemen. Many of these stories add an interesting historical context, such as the fact that no one was willing to sell the city a single piece of land that would allow them to bury the remains of both black and white victims of this disaster.

The Radium Girls: The Dark Story of America's Shining Women by Kate Moore (2017). This book recounts the sad history of the “radium girls”, young women who were employed in the early 1920s and 30s to apply “glow-in-the-dark paint” to the hands and numbers of watch and clock faces. The work involved using their lips to put a very fine tip on their paintbrushes, which was then dipped into the paint, applied to the clock faces, and then repointed in their mouths for the next clock face. This technique, which was taught to the girls, led to the ingestion of the paint. The problem, of course, was that the substance responsible for that eerie glow was radium, a radioactive element first isolated by Marie and Pierre Curie some 20 years earlier. Radium was viewed by some folks during the roaring twenties as a “magical” substance, and was widely advertised as actually having health-promoting properties. However, the radiation emitted by the ingested radium (which migrated into the bones of the radium girls) over a few years destroyed their health and ultimately killed most of them. It became clear to many observers that something in the workplace was killing these young women, but the companies employing them denied that the work was dangerous and refused to compensate them. The radium girls eventually sued their employers, and while a few eventually got a “reasonable” settlement, most got virtually nothing. The focus of the book is on the girls themselves; the business, legal, and science aspects of the story are secondary to the descriptions of their lives, loves, and families. On the negative side, the portraits of many of the girls run together for an obvious reason. Since they all suffered the same type of poisoning, the descriptions of their endless health problems (e.g. loose teeth, disintegrating jawbones, tumors on their arms and legs) are nearly identical but are recounted time and again for each one of them. Though it’s a sad story, the efforts of the girls to live their greatly shortened lives in the best way possible, and to hold the companies that failed to warn them of the dangers accountable, ultimately make this an inspiring read.